Men of Color who have sex with men, and in particular African-American MSM (AA-MSM), continue to account for a disproportionate percentage of the total HIV/AIDS and STI cases among MSM, both nationally and locally in Wisconsin. In Wisconsin, almost two-thirds of newly diagnosed HIV cases in 2005 among African-Americans were attributable to male-to-male sex contact. In response to CDC RFA-PS06-006, the Center for AIDS Intervention Research/Medical College of Wisconsin in collaboration with three community- based organizations who serve AA-MSM- Diverse and Resilient, Inc., the Milwaukee LGBT Community Center, and Charles 'D' Productions- proposes to: (1) Manualize a theory-based and culturally tailored group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. (2) Conduct a randomized phase 3 clinical trial with 220 AA-MSM to compare the effectiveness of a rapid HIV testing and counseling risk reduction intervention (HCT-only) to an enhanced intervention that includes the HCT intervention plus a theory-based and culturally tailored small group intervention designed to reduce HIV and STI risk behavior among AA-MSM. (3) Determine whether key demographic (e.g., age) and theoretical variables (e.g., self-efficacy) moderate or mediate observed intervention effects. (4) Compare the cost- effectiveness of the enhanced HCT-plus small-group intervention relative to the HCT-only intervention to determine whether the greater HIV prevention effectiveness of the HCT-plus intervention is sufficient to justify its greater cost. (5) Disseminate study findings through local community and public health forums and training workshops for providers and community advocates, as well as through scientific presentations and publications. [unreadable] [unreadable] There is an urgent need for HIV and STI prevention interventions for AA-MSM. Our proposed study will address this gap through the conduct and evaluation of an RCT to assess the effectiveness of a culturally- tailored, group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. If demonstrated efficacious, the intervention will be disseminated for use by community agencies who are working to reduce new cases of HIV and STI infection among AA-MSM, a group disproportionately affected infectious disease burden. Such prevention programs will result in improved sexual health among AA-MSM. [unreadable] [unreadable] [unreadable]